Cerebral venous thrombosis: an all or nothing disease? Prognostic factors and long-term outcome
Cerebral venous thrombosis: an all or nothing disease? Prognostic factors and long-term outcome
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DOI：
10.1016/j.clineuro.2004.06.002
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发表时间：
2005-02-01
影响因子：
1.9
通讯作者：
Kaps, M
中科院分区：
文献类型：
--
作者：
Stolz, E;Rahimi, A;Kaps, M
背景：目前关于脑静脉血栓形成（CVT）的短期、尤其是长期预后的资料还不充分。方法：我们分析了79例连续患者的急性死亡、出院时和出院后6个月的功能结局以及大于或等于12个月的长期预后因素。采用美国国立卫生研究院卒中量表（NIHSS）对神经功能缺陷进行评分，采用改良Rankin量表（mRS）对功能结果进行评分。主要结局定义为6个月时mRS大于或等于3，次要结局定义为住院治疗期间死亡，出院后随访期间并发症的数量和类型大于或等于12个月。前瞻性招募42例患者，其中37例通过图表回顾确定。结果的信息是基于我们门诊的神经学检查。结果：与急性死亡相关的因素有年龄、入院时NIHSS、抗癫痫治疗后癫痫发作2次以上、静脉梗死及静脉梗死出血转化。74例患者6个月后的主要结局非常好，73%的患者达到mRS 0-1, 4%的患者达到mRS 2, 23%的患者达到mRS 3-6，包括12例急性期死亡。在逻辑回归分析中，与6个月时mRS大于或等于3显著相关的因素是年龄和入院时与意识相关的NIHSS项目1a-c。58例存活患者随访时间大于或等于12个月（中位数：31个月；平均值：52±61个月）。长期随访中最常见的并发症为癫痫9例，复发性静脉血栓7例。结论：急性期存活后，CVT预后较动脉缺血性脑卒中好。(C) 2004 Elsevier B.V.版权所有
Background: There is insufficient data on short- and especially long-term prognosis of cerebral venous thrombosis (CVT).Methods: In 79 consecutive patients, we analyzed factors for acute death and functional outcome at hospital discharge and after 6 months as well as long-term prognosis greater than or equal to 12 months. Neurological deficits were graded on the National Institute of Health Stroke Scale (NIHSS), functional outcome on the modified Rankin Scale (mRS). Primary outcome was defined as mRS greater than or equal to 3 at 6 months, secondary outcomes were death during hospital treatment and number as well as type of complications during follow-up greater than or equal to 12 months after hospital discharge. Forty-two patients were recruited prospectively, 37 were identified by chart review. Information on outcome was based on neurological examinations at our outpatient clinic.Results: Factors significantly related to acute death were age, the NIHSS on admission, more than two seizures despite antiepileptic treatment, venous infarct, and hemorrhagic transformation of the venous infarct. Primary outcome after 6 months in 74 patients was excellent with 73% of patients reaching a mRS 0-1, 4% a mRS of 2, and 23% a mRS 3-6, including 12 deaths in the acute stage of illness. Factors significantly related to a mRS greater than or equal to 3 at 6 months in a logistic regression analysis were age and items 1a-c of the NIHSS on admission related to consciousness. Fifty-eight surviving patients had a follow-up greater than or equal to 12 months (median: 31; mean: 52 +/- 61 months). Most frequent complication on long-term follow-up was epilepsy in nine patients and recurrent venous thrombosis in seven patients.Conclusions: When the acute stage of illness has been survived, CVT has a good prognosis unlike arterial ischemic stroke. (C) 2004 Elsevier B.V. All rights reserved.